Doctors in the dock

The main roads of Lahore including the Mall Road and the Jail Rd have once again become a battlefield with young doctors pitched against the provincial government and pushing the latter to accede to their demands.

Last week, they tried to enter GOR-1 that houses chief minister’s office as well as residences of superior bureaucrats but were confronted by the police that stopped them from doing so. The protesting doctors were water-cannoned and baton-charged; some of them even taken into custody by the police.

These young doctors, banded together under the banner of Young Doctors’ Association (YDA), have gone on strike in different parts of Punjab and are not attending patients in the Out Patient Departments (OPD) as well as emergencies of public hospitals. This has led to serious problems for patients resulting in deaths of some with critical conditions who were not attended due to the strike and staff shortage at emergencies.

This isn’t the first time the YDA stood up in arms, but this time the one difference is that not all the chapters of the Association are active. As the strike continues, an encouraging development is that the OPDs at Mayo Hospital and Ganga Ram have become fully functional and even the young doctors are performing their duties as required.

Besides, the main emphasis this time around is on the Central Induction Policy (CIP), introduced by the Punjab government, that the protesting doctors want to be set aside.

The CIP is about the selection of doctors for post-graduate training and specialised education. Other demands like regularisation of ad hoc doctors, completion of ongoing projects, removal of the sitting secretary of Specialised Healthcare and Medical Education (SHME) from his post and an end to the alleged victimisation of YDA’s office-bearers are also there. Though there were reports about the strike being called off, what followed was its continuation with full force the very next day.

Dr Shabbir Chaudhry, Spokesman, YDA Punjab, agrees that the young doctors are working at hospitals such as Mayo but rejects the notion of a split within the ranks of the Association. “The doctors are raising their demands on their own and not from the platform of YDA because the Association’s chapter at Mayo has been suspended for the time being,” he tells TNS.

Other demands like regularisation of ad hoc doctors, completion of ongoing projects, removal of the sitting secretary of Specialised Healthcare and Medical Education (SHME) from his post and an end to the alleged victimisation of YDA’s office-bearers are also there.

Chaudhry laments the fact that the government is not taking them seriously, “We were made to wait for eight long hours for a meeting with the committee formed for the purpose but nobody turned up.”

He also condemns the CIP, saying that it meant that the doctors would be selected by the government without sharing the merit details with the public and according to its own whims. “There are reports about use of fake research papers to increase the scores of the applicants,” he says. “Earlier, inductions were made at the local level and the supervisors knew well about those who they had to train. Now, anybody can come in from anywhere.

“The physical and mental fitness of a person to carry out long surgical operations are also not taken into account when making selections.”

While the YDA is pursuing its declared demands, there are reports about some which are not on the paper and being kept off the record. For example, there are criminal cases against the Association leaders, and disciplinary actions are being taken against some for violation of code of conduct.

A source privy to the meetings between the YDA and Punjab government shares that the case of Dr Altamash Kharal, former secretary general of YDA, also came under discussion. Kharal was caught by the Federal Investigation Authority (FIA) while carrying out an illegal kidney transplant and is under judicial remand at the moment. Others like Dr Salman Haseeb are facing disciplinary action for withdrawing both salary as medical officers and stipend as post-graduate students.

According to the source, the government’s point is that it cannot interfere in these processes and only the concerned authorities can decide after thorough investigations.

There are criminal cases against the Association leaders, and disciplinary action is being taken against some for violation of code of conduct. – Photos by Rahat Dar

The YDA members deny this and say they are not negotiating for the release of the said office-bearers. In fact, their demand from the government is they should not be victimised for being part of the YDA. Besides, the inquiries/investigations should be transparent.

They also complain that the Assistant Commissioner of Sahiwal, who forcefully stormed into the hostel of female doctors at night, has still not been taken to task. This is just an example of how the bureaucracy deals with doctors, they insist.

Another demand growing stronger by the day is about the removal of the Specialised Healthcare and Medical Education (SHME) Secretary Najam Ahmad Shah. The young doctors allege that being a non-doctor career bureaucrat, Shah knows little about the issues of doctors and also has no sympathy for them. The fact that he is serving on a senior post despite being in a lower grade is also not acceptable to them.

Akhlaq Ali Khan, a spokesman for the Punjab Health Department, condemns the faction of young doctors on strike saying they are jeapordising the lives of the patients instead of going to the legal forums. “Why can’t they approach the court for the annulment of the CIP if they have strong arguments against it,” he asks.

Khan also says that when the young doctors come for a meeting they leave with the promise to call off the strike but soon afterwards they are back to it. “God knows who they meet in between and who are they getting directions from.”

On the question of the CIP, Khan says it is “irreversible, because it is a computerised and online system that has put an end to irregularities and undue influence in the induction of doctors for post-graduate training.

“In the past, all this was done manually and the doctors as well as academic staff would admit people of their choice in numbers exceeding the available seats. But now the whole system is online and everything on merit.”

The spokesman believes that since the CIP has put an end to their influence and control on inductions, the young doctors are irritated and reacting.

He also terms the demand for removal of the secretary as illogical, “Nowhere is it written that he should be a medical doctor. He is not supposed to conduct surgical operations; in fact, his task is to manage administrative affairs, deal with global organisations like the World Health Organisation (WHO), look after brick and mortar projects like construction of new hospitals, and so on.

“Shall the government seek recommendations from them on who to appoint?”

On the other hand, the YDA spokesman insists the government is not investing in the health sector and that is why a lot of projects are still far from completion. “The one-patient-one-bed policy as demanded by us is also not implemented due to which we have to face the wrath of the patients’ attendants. When people feel ill-treated due to the lack of facilities at hospitals they hold the doctors responsible and manhandle them,” he explains.

The security provided at hospitals is also far from satisfactory and one of the YDA’s demands, as per the spokesman, is that the government should make it foolproof.

Clearly, till the time of filing of this report, both the parties are not ready to budge. The health department has recommended termination of the doctors not joining their duties and refused to do away with the CIP that it claims ensures transparency and puts an end to irregularities. On the other hand, the young doctors are not attending patients, something that has put an extraordinary pressure on those including senior doctors who are trying to make up for their absence.

What is of prime importance is that the patients, especially the serious ones, are not left unattended, regardless of what goes on with the YDA or the government. For the latter, it is imperative to handle the matter on urgent basis.